A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
If you've suffered a serious motor accident injury in Illawarra or South Coast NSW and need home modifications to recover, understanding the Compulsory Third Party (CTP) process is essential. This article explains how to claim home modifications as part of your CTP compensation, what evidence is required, and how SIRA handles these claims. The steps outlined apply to all NSW regions, including Illawarra and South Coast, where injured road users may need accessibility changes after a serious accident.
How CTP Home Modifications Work Under NSW Law
Under the Motor Accident Injuries Act 2017, CTP insurance covers treatment and care benefits for injuries caused by motor vehicle accidents. Home modifications are considered part of 'treatment and care' if they are medically necessary to support recovery. This includes changes like ramps, handrails, or mobility equipment to help injured road users safely stay in their homes.
To qualify, your injury must meet the 'threshold injury' criteria outlined in the Motor Accident Guidelines. This means your injury must be serious enough to require ongoing support, such as a whole person impairment rating of 10% or more. SIRA assesses claims based on medical evidence, not fault, so the at-fault driver’s insurance covers the cost regardless of who was responsible.
Practical Steps for Claiming Home Modifications
- Seek immediate medical attention to document your injury and recovery needs. A doctor’s report must confirm that home modifications are medically necessary.
- Contact SIRA as soon as possible to start your claim. SIRA’s claims team will guide you through the process and request evidence like medical records, a care plan, and a statement from your treating practitioner.
- Provide detailed evidence of your injury’s impact. This includes:
- Medical reports showing the need for home modifications
- A care plan from your treating medical practitioner
- Evidence of your current living situation and how modifications will improve safety
- Any existing mobility aids or equipment you use
- Submit a claim form via SIRA’s online portal or by post. Ensure all documents are clear and directly support your request for home modifications.
Time Limits and Dispute Resolution
You have 52 weeks from the date of your injury to claim certain treatment and care benefits under the CTP scheme. After this period, weekly income payments and some benefits may stop unless your injury is classified as a 'threshold injury' under the Motor Accident Injuries Act 2017. If your claim is denied, you can request a review from SIRA or seek independent legal advice to challenge the decision.
Example: How a Claim Might Work
Consider a cyclist injured in a collision on the Illawarra coast. Their doctor recommends installing a ramp to access their home safely. The cyclist submits a claim to SIRA, attaching medical records and a care plan. SIRA approves the modification as part of the treatment and care benefits, covering the cost of the ramp. This example shows how evidence directly links the injury to the need for home changes.
When to Seek Legal Advice
While SIRA handles most claims, complex cases, such as disputes over the necessity of modifications or overlapping workers’ compensation claims, may require a solicitor. A lawyer can help ensure your claim meets all legal requirements and that you receive all available benefits.
Next Steps
CTP home modification claims depend on the date of your injury, the severity of your condition, and the evidence you provide. To request contact about your circumstances, complete the quick, no obligation enquiry form. Every claim is unique, and understanding your rights is the first step toward securing the support you need.